From Burnout to Breakthrough: Dr. Mohamad Saad on Organizational Alignment and the Power of Physician Coaching

In an era of unprecedented physician burnout and disengagement, Mohamad Saad, MD, MBA, CPE, offers a different approach. An internal medicine physician at HCA Lawnwood Regional Medical Center in Florida, Saad has built a career bridging clinical practice with organizational leadership and coaching. With an MBA in healthcare, board certification in lifestyle medicine, and International Coaching Federation certification, he brings a unique perspective to healthcare leadership challenges.

This transcript has been edited for clarity and length.

Mike Sacopulos: You've had quite a journey from medical school to becoming a physician leader and coach. Can you walk us through that pathway?

Mohamad Saad, MD, MBA, CPE: I'm a polymath and lifelong learner. I graduated medical school almost 20 years ago now and have always pursued a pathway of inquisitiveness and learning. When I was chief of medicine, I took a special interest in learning about the business of managing healthcare. So, I got a four or five-year MBA degree with specialization in healthcare just to learn about the craft of leadership and management.

During my tenure as chief, I was able to help the hospital achieve better numbers with regards to disruptive behavior, patient satisfaction, and some other quality scores. I was then promoted to an associate chief medical officer position where I continued to collaborate with people, and we achieved some interesting successful results with regards to operational efficiency and quality metrics.

Then I was offered an opportunity to build two simultaneous departments — the hospitalist department along with an internal medicine residency program. It was a very enticing goal, and I think we've done a phenomenal job. Throughout those journeys, I've helped hospitals achieve quality metrics and hospital rating improvements, specifically with regard to Leapfrog and patient satisfaction.

What I learned and realized the most is that when you lead such a human enterprise as a hospital department or organization, it all boils down to the human element of it. That's where I took another off-ramp into the makeup and build-up of both the psyche and physique of a human. That's why I got interested in lifestyle medicine and became board certified by the American Board of Lifestyle Medicine. I also became an International Coaching Federation certified physician coach because I truly believe that the ability of a leader boils down to not just the organizational understanding — it's what I call the three P's: process, productivity metrics, and persons.

Sacopulos: You're an expert in organizational alignment. For those unfamiliar with this concept, what exactly is organizational alignment?

Saad: That's a very near and dear topic to me because I think it's crucial to leadership and productivity. I want to start by saying that we have been dealing with a stubborn statistic — about 70% of employees or workers in this country are disengaged. They don't feel like they belong where they work, and that has been a stubborn number for years.

There's another statistic that was beautifully laid out by the World Economic Forum ten years ago. It showed that broadly speaking, some employees are just what they described as "satisfied" — basically focused on salary, survival as an employee, benefits, and doing what they have to do. That paper classified their productivity index as 1.

Now, if you're somebody who's engaged, your productivity can go up to 1.5. If that is dialed up a notch and you're somebody who's inspired — somebody who's got an emotional heart-to-heart connection with the workplace — the productivity can go up to 2.25. So, you're more than twice as productive as base rate productivity. To me, alignment is the combination of what happens when you're both engaged and inspired.

Sacopulos: Can you describe what organizational alignment looks like visually?

Saad: I'd like to describe what I call the alignment triangle. Every organization has a cascade of values that starts with the vision — what is our identity as an organization, what is that destiny? That gets cascaded into a mission — what's our destination, how are we going to get there through strategic plans?

As you go from that central view of the company to the frontline people, those values get cascaded into goals. Those broad goals are broken down into what everybody knows as SMART objectives — specific, measurable, attainable, realistic, and time-based. The craft of a good leader is to further break those SMART objectives down into unique iterations with one deliverable — that's the birth of a project.

If you combine some projects together, you make a program such as a hospitalist program or residency program. If you combine those programs together, you make an ongoing operation such as a hospital.

The whole idea is that middle managers, leaders, or senior leadership really need to keep that visual and make sure that individuals at the very frontline understand that whatever they do — it could be as simple as a one-iteration, quick two-to-three-week project — is in fact in line with the overarching vision and mission laid out by the organization.

There are three broad types of alignment: vertical alignment (connecting vision and mission to frontline projects), horizontal alignment (how an internal medicine doctor aligns with someone from surgery or emergency), and diagonal alignment (how you align with people in pharmacy, physical therapy, or radiology where you don't have a clear direct connection).

Sacopulos: Can you give a specific example of how you've used organizational alignment in practice?

Saad: Absolutely. As a residency program director, residents are supposed to do quality improvement projects. Instead of having the resident pursue a limited endeavor, I aligned their individual frontline effort with the overarching mission of the operation.

The hospital needed improvement in length of stay for heart failure, pneumonia, and COPD — bread and butter operational goals. So, I built that project with the help of hospital leadership and residents, all in line vertically and horizontally with multidisciplinary teams, all hands-on deck. Whatever project the resident executed was in fact to the benefit and in line with the overarching broad goals and mission of the organization.

We had great success with significant reduction in length of stay, and operational efficiency became DNA of the hospital we work at.

Sacopulos: When did you begin coaching fellow physicians, and why?

Saad: It's been about two years now, and it's been a great journey. The good thing about my own path is that I've seen the contrast between being somebody who directs and gives directives versus somebody who's a coach. I'd like to think of a coach as a loving, caring, thinking partner. Instead of having a one-way street where you're pointing fingers and saying "we need to get this done, we're under the gun," a coach is somebody who's a partner in that journey and makes people around you feel heard and helped as they move from point A to point B.

Sacopulos: What makes a great coach?

Saad: Emotional intelligence is key. I recently turned in a manuscript with co-authors about organizations, technology, theory, and leadership, and in the heart of all of this is emotional intelligence.

If I was to break that down, it would be asking very powerful questions, listening with empathy, and listening with curiosity to understand. In the heart of all of this, a coach is a thinking partner who is really aligned with the interests of their coachees. My main target is to help people that I coach reach their very best version of themselves.

Sacopulos: Are some areas of medicine more coachable than others?

Saad: I don't think there have been studies that looked into this, so I can't give you a scientifically backed answer. But what I can tell you is that coaching works for everybody. There have been studies using functional MRIs that showed coaching actually at an organic level yields better results than other forms of just telling people what to do.

The beauty is in the journey of discovery and inquiry that a good coach facilitates — what we call the coaching "aha moment" where you come to a conclusion and think, "How did I ever not find that connection?" That's where you start exploiting great brain resources that I don't think you'll find any other way, and most definitely not when you're being directed under the gun.

Sacopulos: Can you illustrate the difference between a boss and a coach through a practical example?

Saad: Let me do a quick role play. Let's say you're a resident and your in-service exam results came out — they weren't good. As a boss, I might say: "Have you seen your exam results? You scored 50%. That doesn't project that you're going to pass your boards, and I'm going to put you on a study plan. If you don't show improvement, there'll be consequences."

As a coach, I'd approach it differently: "How was your weekend?" You might say it was dark because of the results. I'd respond: "Tell me more about that... Are you feeling anxious? Listen, I have good news for you. Have you ever thought that anxiety is extra energy that you have? I've done this for a long time, and I want to tell you that this anxiety is a lot of energy that you have right now. I'm here so that me and you as a team can figure out how we're going to use that energy to get you to where you need to be."

The difference is profound — one approach sets people up for isolation, disengagement, and loneliness. The other says, "We're in this together, I love you, I care about you, and we're going to make it happen together."

Sacopulos: What does a typical coaching arrangement look like for physicians?

Saad: In the heart of coaching is that this is about you. A good coach won't give you a prescription or dictate how things will work. It's the opposite — you're in charge, it's at your pace, and I'm just partnering with you to help you get to the best version of yourself.

Successful coaching endeavors typically range from three to six months, with meeting intervals every two weeks to keep that stream of thoughts and dialogue going. Usually, every session is 30 to 45 minutes of empathetic listening — there are five levels of listening, and good coaches use levels four and five, which are the best — and asking powerful questions.

Sacopulos: How do you see coaching helping with physician burnout?

Saad: One hundred percent. I just cited in my manuscript that 50% of the American task force is quietly quitting, and the toll on the global GDP that this problem brings is a 9% reduction. What worries me is that AI is coming, and motivation is a balance between intrinsic versus extrinsic factors. AI is essentially an extrinsic motivation or force. If you're intrinsically fatigued, tired, and not prepared, that could actually lead to AI undermining your own motivation to learn, discover, and enjoy the journey of working hard to find that best version of yourself.

Sacopulos: Speaking of AI, how do you think it will impact coaching and physician practice in the future?

Saad: This is probably the topic of our lives. I call this the "alarm maneuver." When the alarm goes off in the morning, did the alarm wake you up, or are you actually the one who set up the alarm, had a nice room temperature, organized yourself for deep sleep, and maybe would have woken up at the same time anyway?

That's how I look at AI. If you're somebody who has built a robust wealth of emotional intelligence, you've had a nice journey, you know how to interact with people and solve problems — AI will probably be a big asset because it will just be another tool in your quiver, making what you do faster and easier.

But if you're somebody who's still struggling with engagement, feeling isolation, and the skill sets aren't really formed yet, and you need to go through the hardship of learning, it may be that the AI extrinsic force will undermine that intrinsic growth that was waiting for you. It all depends on the adoption, and that's where I think regulation is key.

Sacopulos: For physicians interested in coaching or learning more about organizational alignment, how can they reach you?

Saad: I have a LinkedIn profile where people can easily reach out to me, or they can contact me via email. I'm happy to connect with anybody and help however I can.

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